Comparison of Gabapentin v/s Pregabalin for Preemptive Analgesia for Acute Postoperative Pain after Surgery under Spinal Anaesthesia

Abstract

Objectives: Preemptive analgesia involves the introduction of an analgesic regimen, before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain. This study was designed to compare the efficacy of Gabapentin and Pregabalin, with respect to increase in duration of analgesia and reduction in total post- operative requirements of analgesics, along with study of their side effects and complications. Materials and methods: This was a prospective randomized study, conducted on 62 ASA grade I or II patients, aged 20-50 years, having body weight 50-70 kg, scheduled for elective infra-umbilical surgeries under spinal anaesthesia. Total 62 patients were randomly allocated in two groups of 31 each- Group G received tablet Gabapentin 1200 mg while Group P received tablet Pregabalin 300 mg, 1 hour prior to spinal anaesthesia. Pain was assessed by Visual Analogue Scale in immediate postoperative period and every two hourly thereafter. Time since spinal anaesthesia to first dose of analgesic (diclofenac) and total doses of analgesics in first 24 hours was recorded. Results: In Group G rescue analgesic was needed after 10.00 ± 2.02 hours, while in Group P rescue analgesic was required after 14.48 ± 4.48 hours. In Group G subsequent rescue analgesic was required in only three cases while in Group P, subsequent rescue analgesic was required in only two cases. The incidence of somnolence and dizziness was less with Pregabalin than with Gabapentin. Conclusion: Single oral dose of Pregabalin (300 mg) given preoperatively provides better postoperative pain control and decreases postoperative rescue analgesic consumption compared to a single dose of Gabapentin (1200 mg) with fewer side effects.